Cape Side Dental P A
Dentist in Palm Bay, FL. Organization (NPI-2).
NPI number1669780284
StatusActive
Last updated in NPPESJun 15, 2023
Details
- NPI
- 1669780284
- Entity type
- Organization (NPI-2)
- Legal business name
- Cape Side Dental P A
- Organization subpart
- No
- Enumeration date
- Sep 16, 2010
- Certification date
- Jun 15, 2023
- Last updated
- Jun 15, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | DN15346 | FL | Yes |
| 122300000X | Dentist | DN18108 | FL |
Other names
- Capeside Dental (Doing Business As)
- Capeside Family Dentistry (Other Name)
Practice location
3265 Bayside Lakes Blvd SePalm Bay, FL 32909-6872
Phone 321-727-0011 · Fax 321-727-0014
Mailing address
3265 Bayside Lakes Blvd SePalm Bay, FL 32909-6872
Phone 321-727-0011 · Fax 321-727-0014
Other practice locations
4545 Durham Dr
West Melbourne, FL 32904-7610
West Melbourne, FL 32904-7610
Phone 321-733-4711
Authorized official
Samuel Beresford Artley
Owner/Doctor
3217270011
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All 46 Dentist providers in Palm Bay · All 1,789 providers in Palm Bay
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